Revenue Cycle Management

Reveal the providers putting your network at risk right now with the touch of a button.

Even superheroes don't have the time or resources to pull and review thousands of charts manually, and if you're doing random spot checks, you're playing a game of RAC roulette.

REVEAL/md is a secure subscription service that analyzes all of your hospital or network's billing data and shows you in minutes which providers are a current compliance risk, so you can focus on intervention and education before an audit.

If your hospital, health network, or practice isn’t capitalizing on the revenue potential in chronic care management, you’re missing out on profits of Gotham-sized proportions.

Fi-Med uses an award-winning chronic care management system that takes the heavy lifting out of managing the complex regulations of CPT code 99490, leaving you with only one tough job: explaining where all that extra revenue came from.

Fi-Med's coding and billing experts can mind your revenue cycle, so you can mind your patients.

Running an efficient and profitable private practice takes an orchestrated effort, and too often the physician takes on the job of conductor. But if you're spending time negotiating claims and payments and fretting over coding continuity, your attention isn't where is should be: on providing top-quality patient care.

Fi-Med's award-winning Revenue Cycle Management services streamline and manage all of your back-end operations from start to finish, including coding and compliance, billing, claim appeals, payment, and reporting. The dynamic duo of our expert team and our state-of-the-art technology not only keep you Medicare-compliant, but can help recover revenue you didn't know you were losing.

Critical tools for a fast-changing industry, brought to you by the leaders in coding and compliance.

Since 1993, Fi-Med has been working alongside healthcare providers and networks to maximize revenue and reduce risk—from catching billing errors to providing high-level safeguards against compliance risk. We’ve grown exponentially over the last 25 years, becoming trusted experts in the fields of financial healthcare management, compliance and risk assessment, and chronic care management.

Today we continue to develop and partner with some of the most robust and full-featured products and services for our customers in these markets, including:

REVEAL/md

Cloud-based subscription analytics service that turns your monthly non-PHI billing data into an instant, comprehensive report of which physicians are putting your network at risk for compliance violations and/or lost revenue, and why.

Chronic Care Management

Revenue Cycle Management

Fi-Med's flagship suite of services—billing, coding, claim appeals, lockbox services, and more—have helped thousands of physicians and labs maximize revenue and minimize time spent on administrative tasks. Twenty years later, we continue to use the latest technology and best practices to help physicians navigate a complex healthcare billing environment and keep a healthy bottom line.

Fi-Med has been the recipient of numerous awards and accolades, including the 2006 Award for Business Growth in Wisconsin, and the 2006 Congressional Award for Outstanding and Invaluable Service to the Community. In 2007, Fi-Med founders Adrian Velasquez and Christine Krause were selected to receive the Small Business Administration’s Small Business Persons of the Year Award.

Billing can be a frustrating part of physicians’ practices at a time when reimbursement is declining and administrative burdens are increasing on physicians and hospital systems. Adrian Velasquez, Wisconsin based co-founder and CEO of Fi-Med, a predictive analytics provider that aims to help physicians and medical systems improve cash flow and reduce compliance risk, has tips for finding common billing mistakes that cost a practice revenue.

In 2018, 751 hospitals across the country face substantial Medicare penalties for patient injuries. But coding errors are also to blame—and these might have been avoided with risk-based auditing software.

Healthcare spending has exploded since the 1970s, in part due to the growing number of administrators needed to oversee compliance issues. To remain compliant and keep more of their money, organizations should use risk-based auditing software solutions.

According to the latest statistics, over 1.6 million new cases of cancer are diagnosed in the United States each year.(1) As the number of cancer cases grows, treatments for cancer, including chemotherapy, radiation therapy and surgery, are utilized often at healthcare centers nationwide. But in some healthcare facilities, problems with the medical coding process lead to overbilling for cancer drugs and treatment services, having disastrous consequences for providers, patients, and the healthcare system as a whole.

Due to overbilling practices, Carolinas HealthCare System (CHS) violated the False Claims Act and will pay a settlement of $6.5 million. Former CHS lab director Mark McGuire was the whistleblower in this case, contending that CHS was improperly upcoding urine drug test claims in an effort to receive higher payments, than if they properly billed for these tests. Under the False Claims Act, Mr. McGuire was able to file a lawsuit on the government’s behalf and potentially receive a portion of the recovery. As happened in this case, the government has an opportunity to intervene and take over the action. The government was able to conduct a thorough investigation into the allegations and reach a settlement.

Adrian Velasquez, president and CEO of Fi-Med, says, "The complexities involved in anesthesia coding and billing are enough to make anybody's head spin. Providers must have a higher level of coding skills in order to correctly bill for services, but many anesthesiologists don't have this knowledge. However, healthcare systems are implementing change by using analytic technology to identify coding problems within their records. This helps to show which providers are putting the organization at increased risk for compliance issues and audits."

Incorrect coding is to blame for nearly half of improper claims submitted to Medicare, and the monetary losses increased from $57.8 billion in Medicare and Medicaid payments in 2015, and $68 billion in 2016. When the government is unsure what’s going on, it carries out what doctors dread: audits.

Hospitals and health systems countrywide declare bankruptcy due to many factors, ranging from patient non-payment to provider “up-coding” inaccuracies which lead to audits. To lower their bankruptcy risk, facilities should implement risk-based analysis solutions to find errors early.

Federal health officials, who made more than $60 billion in improper payments to private Medicare Advantage health plans and Medicare in 2016, are evaluating how to crack down on billing errors by hospital systems. Overpayments to hospital systems result in large hospital revenue loss from eventual audits.

Have you been hit with rankings from insurance companies that do not designate your practice as "superior quality" because you are missing records from a non-associated clinic? Or that your treatment patterns are too aggressive and you are over-treating your patients and being designated by your insurance as a "Lower" Tiered Provider in which the patient seeing you has higher out-of-pocket expense? Do you experience challenges meeting the new MACRA requirements? Let's begin today in proving our outcomes and improving the quality of our chronic patients care.

The Health Ethics Trust is pleased to welcome FI-MED and REVEAL/md Clients and Special Guests to join us at the 2016 Healthcare Best Compliance Practices Forum being held October 17 – 18 at the Ritz-Carlton Pentagon City hotel in Arlington, VA (DC Metro Area).

Over the last few years, most hospitals and health care networks have found themselves being shuffled into and through the pipeline of new standards in patient care—a transition sparked by The Centers for Medicare and Medicaid Services (CMS) and commercial payers from a quantity-based to a quality-based system.

CBR reports show the provider how he/she compares to peers in the same specialty locally and nationally, and are intended to give providers an opportunity to seek additional training and to review Medicare guidelines to ensure compliance.

When Adrian Velasquez pitched his high-tech start-up idea, banks balked at the risk proposition.These days, with business partner Christine Krause at his side, Fi-Med Management, Inc. is one of the fastest-growing firms in the country.

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Fi-Med is a 25-year leader in the healthcare support and management industry. Our strong reputation for protecting and recovering revenue for hundreds of hospitals, labs, private physicians, and healthcare networks means we have a 360-degree understanding of healthcare compliance, chronic care management, and revenue cycle management. Learn more about us.